Individual provider Active NPI

Elisee Jionang Dapeu

  • Family Medicine Physician
  • Kirkland, WA
National Provider Identifier
1326667148
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.MD.61524687 Issued in WA
Practice address
12710 Totem Lake Blvd NE
Kirkland, WA 98034-2907
Phone
(425) 821-4040
Fax
(425) 820-5060
NPI assigned
Apr 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X WA
Family Medicine Physician 207Q00000X MD.MD.61524687 WA Primary

Addresses

Primary practice location

12710 Totem Lake Blvd NE
Kirkland, WA 98034-2907

Mailing address

12710 Totem Lake Blvd NE
Kirkland, WA 98034-2907
Phone (425) 821-4040

Other practice location 1

1700 13th St
Everett, WA 98201-1689
Phone (425) 261-2000

Other practice location 2

9710 State Ave
Marysville, WA 98270-2232
Phone (360) 657-3052 ext. 13022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230110001096 WA Practitioner - Family Practice 6002286929 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1909 214TH St SE
Suite 110
Bothell, WA 98021-4412
Phone (425) 488-4988

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.MD.61524687WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 Family Medicine CurrentSince Apr 6, 2024 Accepting new patients
Sea Mar Community Health Centers Family Medicine CurrentSince Oct 1, 2022 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Apr 6, 2024 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Sea Mar Community Health Centers CurrentSince Oct 1, 2022 Accepting new patients
Sea Mar Community Health Centers Family Medicine Current Accepting new patients
King County Public Hospital District No 2 Family Medicine Current Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

14720 Main St NE
Ste 109
Duvall, WA 98019
Phone (425) 788-4889

1700 13th St
Everett, WA 98201
Phone (425) 252-0895

12710 Totem Lake Blvd NE
#144
Kirkland, WA 98034

12710 Totem Lake Blvd NE
Kirkland, WA 98034
Phone (425) 821-4040

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

9710 State Ave
Marysville, WA 98270
Phone (360) 653-1742

17707 W Main St
Fl 1
Monroe, WA 98272
Phone (360) 282-3885

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1326667148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12710 TOTEM LAKE BLVD NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342907",
            "telephone_number": "425-821-4040",
            "fax_number": "425-820-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12710 TOTEM LAKE BLVD NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342907",
            "telephone_number": "425-821-4040",
            "fax_number": "425-820-5060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 13th St",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982011689",
            "country_code": "US",
            "telephone_number": "425-261-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9710 State Ave",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "WA",
            "postal_code": "982702232",
            "country_code": "US",
            "telephone_number": "360-657-3052 x13022",
            "fax_number": "360-657-3057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIONANG DAPEU",
        "first_name": "ELISEE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-11",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD.MD.61524687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.